Possibilities and Limitations in the Recording of the Onychomycoses During Treatment

Abstract

The majority of patients first present to the specialist in an advanced stage of onychomycosis [8]. This means that at the time treatment is begun a large part of the nail plate has been affected by the mycosis [2]. Quite apart from whatever type of treatment is chosen, it takes a very long time to confirm the definitive success of treatment, and this is really only the case when the patient once again possesses a nail plate that is completely fungus-free and altogether clinically inconspicuous [7]. It is obvious that clinical normality is attainable only in those cases in which no aggravating local factors have been superimposed on the mycosis. Even with the normal growth of the toenails of about 1 mm a month, it takes about 12 months for the healthy regrowth of a nail plate completely affected by fungi. However, in many patients with onychomycosis nail growth is retarded [9]. This is due to various local factors, which originally also favored the onset of the fungus infection [3, 5, 7]. In these cases the period between the beginning of treatment and the attainment of its objective is often still considerably longer than the year just mentioned.